不同治疗方法对晕痣疗效的影响因素分析

目的 探讨晕痣临床特征及疗效影响因素。方法 对2016年2 - 11月门诊晕痣患者临床资料进行前瞻性研究，分析影响晕痣疗效相关因素。结果 250例患者共293处皮损，单发219例（87.6%），多发31例（12.4%）；皮损位于躯干部154处（52.6%）、面颈部127处（43.3%），直径5 ~ 20 mm。248例（99.2%）晕痣在自然病程中未完全自发消退。122例（48.8%）患者伴发白癜风。单因素分析显示，年龄、皮损数目、伴发白癜风和治疗方法是晕痣疗效的影响因素，多因素logistic回归分析显示年龄 ≤ 19岁或 ≥ 40岁、病程 > 1年、皮损单发、不伴发白癜风、接受祛痣治疗是晕痣治疗有效的独立影响因素。结论 大部分晕痣不能完全自发性消退。CO2激光或手术祛痣联合外用药是治疗晕痣的有效方法，未伴发白癜风晕痣患者可优先祛痣，伴白癜风者可在白癜风稳定后祛痣。多发晕痣或白癜风面积较大者更易复发，应密切随访。

Analysis of factors influencing treatment outcomes of halo nevus

Hu Wenting, Huang Jun, Xu Ai′e Department of Dermatology, Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310009, China Corresponding author: Xu Ai′e, Email: xuaiehz@msn.com 【Abstract】 Objective To investigate clinical characteristics of halo nevus, and to explore factors influencing its treatment outcome. Methods A prospective study was conducted in 250 patients with halo nevus from February 2016 to November 2016 to analyze the factors influencing treatment outcomes. Results There were a total of 293 lesions in the 250 patients, including 219 （87.6%） patients with solitary lesions and 31 （12.4%） with multiple lesions. Among these lesions, 154 （52.6%） occurred on the trunk, and 127 （43.3%） occurred on the face and neck. The diameters of the lesions ranged from 5 mm to 20 mm. Not all the halo nevi spontaneously subsided in 248 （99.2%） of the 250 patients, and 122 （48.8%） of the patients were complicated by vitiligo. Univariate logistic regression analysis showed that age, number of lesions, complication by vitiligo and therapeutic methods were factors influencing the treatment outcome of halo nevus. Multivariate logistic regression analysis revealed that age ≤ 19 years or ≥ 40 years, disease duration > 1 year, solitary lesions, absence of vitiligo and nevus removal were independent factors for effective treatment of halo nevus. Conclusions Most of halo nevi cannot subside spontaneously. CO2 laser or surgical excision combined with externally applied agents is effective for the treatment of halo nevus. For halo nevus patients without vitiligo, it′s preferred to remove the halo nevi. For halo nevus patients with vitiligo, nevi should be removed in the stable stage of vitiligo. Relapse often occurs in patients with multiple halo nevi or large-area vitiligo, so close follow-up is needed.